The Multicenter Network of Neonatal Intensive Care Units (NRN) was established by the NICHD in 1986 to rapidly design, conduct and publishes clinical trials in high priority areas. We are one of only two centers that have successfully competed in every round since 1986. We are excited by the prospect of continuing our participation in the NRN. We will demonstrate that we continue to unquestionably meet all the requirements for inclusion as a center. Our personnel are unparalleled in their expertise and productivity as evidenced by our consistently high enrollment rates in all trials and our follow-up rates which exceed 90%. Our enrollments are consistently among the highest in the NRN because our dedicated personnel recruit 24/7 including nights, weekends and holidays. In addition, both our medical and nursing staffs believe unequivocally that patient care is improved through research, encourage families to participate, and are committed to meticulous adherence to protocols. Our large diverse inborn delivery service with essentially no loss to back transport is ideal for neonatal clinical trials. We have a full complement of pediatric subspecialists (including actively engaged co-investigators in Pediatric Surgery, Ophthalmology and Cardiology) available to conduct trials. In addition, CWRU brings special expertise in Pediatric Pharmacology, Pulmonology, Biomedical Engineering, Respiratory Therapy, and the Proteomics and Genomics Cores at the CWRU CTSA that all enrich the NRN. We have not only shown exceptional ability to collaborate with other centers, but we have assumed many leadership roles. We have set the bar for long term follow-up. Centers across the country, and indeed across the world, have implemented CWRU methods to track former preterm infants into adulthood with excellent retention. CWRU has consistently enhanced the productivity of the NRN at every cycle transition by mentoring new centers to enable them to rapidly implement IRB submissions, enrollment, and adherence to protocols. We have the firmest institutional backing with commitments of space and resources from the CWRU School of Medicine, University Hospitals Case Medical Center, the Departments of Pediatrics and Reproductive Biology and the Divisions of Neonatology and Maternal Fetal Medicine. We eagerly anticipate the next cycle of the NRN and will continue to lead and innovate.